Individual
RYAN BOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1919 ELM ST N, FARGO, ND 58102-2416
(701) 234-6076
Mailing address
6807 94TH AVE SE, LAMOURE, ND 58415-8952
(701) 830-9739
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
RL21050
ND
Other
Enumeration date
04/27/2024
Last updated
04/27/2024
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